The protective effect and mechanism of ischemic preconditioning for hepatic resection under hepatic blood inflow occlusion in hepatocellular carcinoma patients with cirrhosis / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the protective effect of ischemic preconditioning (IPC) for hepatic resection under hepatic blood inflow occlusion (HBIO) in hepatocellular carcinoma patients with cirrhosis and its possible mechanism.</p><p><b>METHODS</b>29 consecutive patients resectable HCC were randomized into two groups. IPC group before HBIO, IPC with 5 min of ischemia and 5 min of reperfusion was given; control group simple HBIO. The liver function, hepatic caspase-3 activity, and apoptotic cell were compared between the two groups.</p><p><b>RESULTS</b>The AST, ALT levels of POD 1, POD 3 and POD 7 in the IPC group were significantly higher than those of the control group, respectively (t = 4.238, P < 0.05). The TBIL levels of POD 3 and POD 7 in the IPC group were significantly higher than those of the control group, respectively (t = 2.296, P < 0.05). The ALB of POD 1 in the IPC group was higher than in the control group (t = 2.029, P > 0.05). After 1 h of reperfusion, the hepatic caspase-3 activity and apoptotic sinusoidal endothelial cell were significantly higher than those of in the control group (t = 2.349, P < 0.05).</p><p><b>CONCLUSIONS</b>IPC has the a protective effect in hepatic resection under HBIO in HCC patients with cirrhosis. Its mechanism is that sinusoidal endothelial cell apoptosis is inhibited by inhibiting caspase-3 activity.</p>